Avatar therapy: a new treatment for schizophrenia?

A new experimental therapy, which involves face-to face interaction between a person with Schizophrenia and an avatar representing their auditory hallucinations, may help reduce symptoms.

Hallucinations are a common symptom of schizophrenia and around 60-70% of patients experience auditory hallucinations which are threatening or insulting. Even with the use of drugs and cognitive therapy treatment, one in four patients still hears voices. Schizophrenia can be an incredibly distressing condition and avatar therapy offers a potential solution to this. Professor Tom Craig from King’s College says that “it is important we look at newer, effective and shorter forms of therapy.”

The pilot study in 2013 used a much smaller focus group but highlighted a significant reduction of the severity of symptoms. These positive results led to the recent larger trial, with 150 people who had suffered with schizophrenia for 20 years and heard an average of 3-4 voices. Of the 150 patients, 50% received Avatar Therapy and 50% Supportive Counselling. All patients continued with their usual antipsychotic medication throughout the trial. The results of the trial, published in the Lancet Journal, indicate that patients who received avatar therapy treatment became less distressed and heard voices less often.

Avatar Therapy sessions consisted of 50 minute sessions for six weeks. Before the treatment patients also worked with therapists to construct their avatar, using a computer program to build a face and voice to match one of their voices. The therapy involved a three-way conversation between the patient, therapist and avatar. The patient would speak to the avatar on the computer screen and the therapist, in another room, would speak as themselves and as the avatar.

Professor Tom Craig, study author from King’s College London, said that through conversation with their avatars, patients learnt to stand up to them and take control of the conversation; “shift(ing) the idea that the voice is all-controlling.” The sessions were also recorded and given to patients to take home and listen when they heard the voices.

The supportive counselling sessions ran for six weeks and encouraged patients to discuss any problems or issues of concern. At the end of the session, each patient was required to record a positive message which would be played to them the following week. After 12 weeks avatar therapy patients were found to have improved more significantly.

Despite the merits of this new treatment, researchers have noted some limitation to the study. Counselling was conducted by graduate trainee therapists, perhaps impacting its’ effectiveness. Also, Professor Craig has said that they need to find out whether the therapy can be replicated in other locations before it is made available through the NHS. Nevertheless, he maintains that the research findings are a “significant advance” in treating hallucinations.

Sir Robin Murray, professor of psychiatric research at King’s College London’s Institute of Psychiatry, believes that if those results were replicated in different locations then ” a wholly psychological intervention such as avatar therapy (could) produce such an improvement (and) make us rethink the way we conceptualise auditory hallucinations.”